Table of ContentsView AllTable of ContentsTNM SystemStage 0Stage 1Stage 2Stage 3Stage 4Survival Rates
Table of ContentsView All
View All
Table of Contents
TNM System
Stage 0
Stage 1
Stage 2
Stage 3
Stage 4
Survival Rates
If you’ve been diagnosed withmelanoma, a serious type ofskin cancer, your tumor is classified based on a stage.
Cancer staging is a way to describe how serious the disease is. The five stages of melanoma range from stage 0 (least serious) to stage 4 (most serious).
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Youroncologist, a doctor who specializes in cancer, decides how to treat the disease based on its stage.
In this article, you’ll learn what helps define each stage and what staging means in terms of prognosis.
TNM Staging of Melanoma
The American Joint Committee on Cancer (AJCC) melanoma staging system, which came into use on January 1, 2018, is widely used for defining the stages of melanoma.
It’s based on the TNM system, in which each letter refers to specific aspects of melanoma.
“T” Is for Tumor
The T used in melanoma staging refers to how large and thick the growth is. It also indicates if the tumor has ulcerated, or broken through to the skin beneath it.
After that, there is usually a letter to indicate if the tumor has ulcerated.
“N” Is for Node
A melanoma that doesn’t involve the lymph nodes will be labeled as N0. A melanoma that does involve the lymph nodes will be labeled as N1, N2, or N3, depending on how many lymph nodes are affected, or if there are local metastases that haven’t yet reached a lymph node.
A letter (“a” to “c”) after a number greater than zero indicates how many (if any) nodes are affected, whether they’re detectable only with biopsy or with a clinical, radiological, or ultrasound examination.
What Are Lymph Nodes?Lymph nodes are small structures that filter substances and help fight infection. They are part of a network that runs throughout the body. Cancer that reaches the lymph nodes is concerning because cancer cells can spread to other parts of the body through this interconnected system.
What Are Lymph Nodes?
Lymph nodes are small structures that filter substances and help fight infection. They are part of a network that runs throughout the body. Cancer that reaches the lymph nodes is concerning because cancer cells can spread to other parts of the body through this interconnected system.
Melanoma tumors also may spread to lymphatic channels, thin tubes that resemble blood capillaries, through whichlymphfluid flows.
“M” Is for Metastasis
When cancer cells spread to a part of the body far from the original tumor site, it is said to havemetastasized. This can mean the cancer is advanced and may be hard to treat.
The organs melanoma most often spreads to are the lungs, liver, brain, and bones.
Recap
Melanomas are staged based on three characteristics of the tumor:
A melanoma that’s caught early, while it’s still small and hasn’t affected the skin underneath it, is known asmelanoma in situ.
It may be labeled as stage 0 orTis.
Melanoma in situ almost always can be cured. It is usually treated with a procedure known as wide excision, in which the tumor and a small amount of the healthy skin around it are removed.
Melanomas in this early stage have not spread to other parts of the body. They are staged based on size, thickness, and whether they have ulcerated.
There are two categories of stage 1 melanoma:
Stage 1A
Stage 1B
In stage 2 melanoma, the cancer is larger than in stage 1 and has not spread to other parts of the body. It may or may not have ulcerated.
Stage 2A
Stage 2B
Stage 2C
How Early Stage Melanoma Is Treated
At this stage, the tumor has affected at least one lymph node and perhaps more. There may or may not be satellite tumors and there may or may not be cancer cells in lymphatic channels. The tumor has not metastasized to other parts of the body.
Stage 3A
Stage 3B
Either:
Or:
The tumor measures no more than 4 mm thickness, may or may not have ulcerated, and has done one of the following:
Stage 3C
There are four possibilities in this stage:
Stage 3D
The tumor is thicker than 4 mm and ulcerated and has spread to:
Stage 4is the most advanced stage of melanoma. It’s the only stage in which cancer cells have spread to one or more distant body parts.
Once this happens, the melanoma is given a stage 4 classification no matter how big the original tumor is, whether there are satellite tumors, or whether any lymph nodes or lymphatic channels are affected.
RecapWithin each of the five stages of melanoma there are lots of substages. These depend on factors such as the exact size of the tumor, how many lymph nodes are involved (if any), and whether there is ulceration. Higher numbers within each stage corresponds to more extensive cancer.
Within each of the five stages of melanoma there are lots of substages. These depend on factors such as the exact size of the tumor, how many lymph nodes are involved (if any), and whether there is ulceration. Higher numbers within each stage corresponds to more extensive cancer.
How Late-Stage Melanoma Is Treated
Melanoma Survival Rates
There’s no way to predict exactly how a disease like melanoma will progress for an individual person because some people have cancer that advances rapidly from one stage to another, and not everybody’s cancer responds to treatment in exactly the same way. Your underlying health may play a role too.
That said, most experts talk about melanoma outcomes in terms of five-year survival rate.
What Is a Five-Year Survival Rate?Five-year survival rate refers to the average number of people with a particular disease or condition who are alive five years after being diagnosed.
What Is a Five-Year Survival Rate?
Five-year survival rate refers to the average number of people with a particular disease or condition who are alive five years after being diagnosed.
Cancer experts base five-year survival rates for melanoma on information from the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program database (SEER).
Survival statistics from the SEER database are not based on AJCC melanoma staging. Instead, they’re based on if and how far the melanoma has spread:
The five-year survival rate for all three SEER stages combined is 93%.
Summary
Healthcare providers use the TNM staging system to define the severity of a case of melanoma. Knowing this allows them to figure out the best way to treat the disease.
This system looks at three specific aspects of a melanoma: tumor size and depth (T), lymph node involvement (N), and metastasis (M).
The five stages of melanoma are based on this information. The earliest, stage 0, is highly curable. The most advanced, stage 4, tends to be challenging to treat.
Five-year survival rates for melanoma are based on whether the cancer has spread and to what degree.
Skin Cancer Doctor Discussion GuideGet our printable guide for your next doctor’s appointment to help you ask the right questions.Download PDFEmail AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
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5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Gershenwald JE, Scolyer RA, Hess KR, et al.Melanoma staging: evidence-based changes in the American Joint Committee on Cancer eighth edition cancer staging manual.CA Cancer J Clin. 2017;67(6):472-492. doi:10.3322/caac.21409
UpToDate.Patient education: melanoma treatment; advanced or metastatic melanoma (beyond the basics).
American Cancer Society.Melanoma skin cancer stages.
National Cancer Institute.Cancer stat facts: melanoma of the skin.
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